Individual provider Active NPI

Brandi Fagan Gosdin, P.A.-C.

  • Medical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1366569691
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PENDING Issued in TX
Practice address
800 5TH Ave
Suite 300
Fort Worth, TX 76104-7300
Phone
(817) 334-1400
Fax
(817) 878-5217
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PENDING TX Primary

Addresses

Primary practice location

800 5TH Ave
Suite 300
Fort Worth, TX 76104-7300

Mailing address

9003 Airport Fwy
Suite 300
North Richland Hills, TX 76180-7770
Phone (817) 514-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070728000177 TX Practitioner - Physician Assistant 0749381168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6161 N State Hwy 161
Irving, TX 75038-2220
Phone (972) 258-7499

7501 Lakeview Pkwy
Suite 130
Rowlett, TX 75088-9324
Phone (972) 463-3100

900 Airport Fwy
Suite 158
Hurst, TX 76054-3253
Phone (817) 514-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGTXMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC CurrentSince Mar 26, 2007 Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Mar 26, 2007 Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

800 5th Ave
Ste 300
Ft Worth, TX 76104
Phone (817) 334-1400

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

9003 Airport Fwy
Ste 300
Richland Hills, TX 76180

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: brandi.gosdin@wellmed.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366569691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9003 AIRPORT FWY",
            "address_2": "SUITE 300",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807770",
            "telephone_number": "817-514-5200",
            "fax_number": "817-514-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE",
            "address_2": "SUITE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047300",
            "telephone_number": "817-334-1400",
            "fax_number": "817-878-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSDIN",
        "first_name": "BRANDI",
        "middle_name": "FAGAN",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.